1. Field of the Invention
This invention pertains generally to devices and processes for selecting, designing, modeling, correlating and scaling of superimposed images. More particularly, the invention is an image comparison apparatus and method for use in medical and dental pre-operative planning and post-operative analysis, which allows a medical transparency, such as an x-ray film, to be superimposed with a computer-interfaced display and held securely therewith, and which further allows a surgeon to quickly and easily manipulate a displayed digital implant image on the computer display in superposition with the medical transparency, for correlating, comparing, scaling, designing and selection of medical implants.
2. Description of the Background Art
The modern day orthopedic surgeon, in preparing for a hip transplant or like surgical procedure, generally completes the pre-operative planning process using inefficient and inaccurate techniques for selection of prosthesis for surgical implanting. Typically, a medical x-ray film image and light panel, together with a protractor, scale and pen or pencil, are the only items used by surgeons in selecting a prosthesis. The scale of the x-ray is estimated by using inaccurate markers exposed on the x-ray film. The surgeon sketches a series of circles, lines and angles directly onto the x-ray film and then uses the sketched features to make an estimation of the necessary prosthesis. This estimation is also relied on for selection of the instruments required for the surgery and evaluating the general complexity of the surgical procedure. This estimation process is sometimes aided by the use of a series of transparent templates which represent possible implant choices. The above procedure relies heavily on the experience and intuition of the surgeon making the estimations and is time consuming and prone to inaccuracy, and can result in non-optimal implant selection and unfavorable surgical outcomes.
Various pre-operative planning systems have been devised to improve efficiency and accuracy in choosing medical and dental implant and other prostheses. Such systems typically utilize digitized medical scan data (CT, NMR, x-ray) upon which computer-run algorithms are used to generate a prosthesis model. The digital model thus generated can then be scaled and manipulated with the digital scan data. These systems, however, are generally difficult and expensive to implement, and have proven to be incompatible with current pre-operative planning environments. Particularly, the software associated with such pre-operative planning systems is complex and unfamiliar to the surgeons planning operations, and thus additional personnel must be present to operate the systems. Even when such systems are available, the time and complexity involved result in surgeons being disinclined to utilize the systems.
Also known are hand-held measurement devices which can be set on top of an underlying image, such as a map, so that a user can look through the display and see a cursor point or points on top of the underlying image and can make a measurement of the underlying image by moving a cursor. Such hand-held measuring devices have proved to be limited in scope and application. Additionally, a user must typically hold the device in position with one hand, leaving only one hand free to enter data, make notes, or carry out other operations. The use of such hand-held measuring devices has been generally limited to xe2x80x9ctabletopxe2x80x9d applications wherein gravity can provide limited assistance in holding the measuring device in place.
Accordingly, there is a need for an image comparison apparatus and method which can be used for preoperative planning for medical implant design and selection, which allows a transparency and a displayed complex image to be assembled and held in a stationary relationship when comparisons are being made, which is quick and accurate, which is easy to implement and use, which is compatible with standard medical and dental preoperative planning environments, and which can be used directly by surgeons without any training or requiring additional personnel. The present invention satisfies these needs, as well as others, and generally overcomes the deficiencies found in the background art.
The present invention is an image comparison apparatus and method for use in medical implant design, scaling and selection, which allows quick and accurate comparison of a displayed image with a superimposed image on a transparency, which allows sizing and selection of implantable prosthesis for individuals, and which is compatible with current preoperative procedures and can be used directly by surgeons.
In general terms, the invention comprises a display, means for illuminating the display which are coupled to the display, means for superimposing a transparent medium with the display and holding the transparent medium, display and illuminating means in a stationary relationship, and a computer, operatively coupled to the display and including user interface means for inputting instructions to the computer. Program means, associated with the computer, provide for generating, displaying and manipulating digital images on the display according to input from said user interface means. The digital image is displayed in superposition with an image or images present on the transparent medium. The transparent medium may be interposed between the display and illuminating means.
By way of example, and not of limitation, the display may comprise generally any type of digital display having a plurality of pixels thereon which are responsive to a computer or like data processing means. More preferably, the display used with the invention comprises a transparent flat panel display, preferably an active matrix or passive matrix transparent LCD screen having a plurality of liquid crystal-based pixels, positioned between transparent conductors, with each pixel separately addressable by the computer. The transparent medium preferably comprises a flat transparency in the form of a flat, resilient sheet such as a medical x-ray film, and has thereon an image such as the x-ray image of a human joint.
The means for superimposing a transparent medium with the display and holding the transparent medium, display and illuminating means in a stationary relationship is preferably provided by a transparent back panel, associated with the illuminating means, which is pivotally coupled to the LCD screen along one edge. The pivotally coupled transparent panel and LCD screen are structured and configured to receive a flat transparency, such as a medical x-ray film, in between the back panel and the LCD screen in a xe2x80x9cclamshellxe2x80x9d arrangement. The transparency is placed in between the LCD screen and transparent panel when the LCD screen and transparent panel are in an open position, and the transparency, LCD screen and illuminating means are assembled and held together in a fixed position or stationary relationship when the LCD screen and transparent panel are in a closed position. The illuminating means preferably comprises a back light associated with transparent panel that is hinged to the LCD screen. Generally, the touch screen interface of the invention is coupled to and superimposed on LCD screen, and the superimposing means of the invention thus also provides means for releasibly holding the touch screen, as well as the transparent medium, display and illuminating means, in a stationary relationship.
The computer used with the invention may be any standard data processing means or system, and preferably comprises a conventional personal computer having RAM, ROM and input/output or I/O means for information transfer. The preferred user interface means comprise a xe2x80x9ctouch screenxe2x80x9d interface which is superimposed with, and preferably integral to, the hinged LCD screen. The user interface means also preferably comprises a touch pad, which may be associated with a second LCD screen and illuminated by the back light. The touch screen and touch pad user interfaces are operatively coupled to the computer and allow a user to enter instructions to the computer. The user interface means may additionally or alternatively comprise a conventional keyboard and xe2x80x9cmouse.xe2x80x9d The input/output or I/O means for uploading and downloading information to and from the computer are preferably comprise one or more floppy disc drives, optical computer disc or CD drives, a printer/facsimile machine, and network interface means in the form of a modem, xe2x80x9cbrowser softwarexe2x80x9d and telephone interface for accessing other computers and data bases. Means for providing and receiving market data services, means for receiving new product information, means for receiving advertising information, means for subscribing to and maintaining electronic catalogues or databases, means for monitoring product inventory and usage, and means for accessing manufacturer representative information, are preferably included with the invention, and are preferably associated with the computer.
The program means comprises software residing in the RAM and/or ROM of the computer, which carries out generally the operations of allowing a user to select a viewing mode, allowing a user to select a digital image type for display on the LCD screen, allowing a user to select a view (orientation) of the digital image, allowing a user to carry out primary and advanced spatial manipulations of the digital image, allowing a user to display and manipulate additional digital images, and allowing a user to record and export information regarding the displayed digital image.
The invention is particularly well suited for use in preoperative planning processes for designing, scaling or selecting implants or prosthesis for subsequent use in surgery. In this regard, the program means of the invention also preferably comprises software which carries out the operations of pre-operative planning analysis, post-operative outcome analysis, compiling (non-confidential) patient data for transfer to market data services, accessing electronic catalogs and databases of implant and prostheses products, updating new implant and prostheses product information, the ordering and monitoring of implant or prosthesis inventory, receiving manufacturer advertising information, and requesting and receiving manufacturer information.
The backlight, LCD screen and computer of the invention are preferably embodied in an apparatus which is wall-mounted. The touch screen controls of the user interface are designed to intuitively allow a surgeon to generate, display and manipulate graphical representations of medical implants, together with the familiar scaling tools (protractor, ruler, sphere and cylinder), and to xe2x80x9cdrawxe2x80x9d on the displayed implant image with a computer generated pen or pencil, in a manner similar to that used in current preoperative planning. In this manner, the invention is highly compatible with existing preoperative planning environments and is very user friendly to surgeons planning operation procedures.
In operation, the user of the invention, who will typically be a surgeon, places a medical transparency such as an x-ray film, in between the hinged LCD screen and transparent panel on the back light, and closes the LCD screen against the panel and back light to hold the medical transparency in place between the backlight and the LCD screen. When the LCD screen is closed against the panel, the touch screen, LCD screen, transparency and back light are assembled in superposition and held in a stationary relationship so that the transparency cannot undergo unwanted movement with respect to the LCD screen and the digital images displayed thereon. The backlight is activated to illuminate the superimposed medical transparency and LCD screen. Preferably, the back light is interfaced with or operatively coupled to the LCD screen so that the brightness level of the backlight can be adjusted by the user through touch pad or touch screen controls.
The touch pad and touch screen are used to select and display a digital graphical model or image of a medical implant on the LCD screen, and the user views the implant image and the superimposed image on the medical transparency. The user is provided with multiple implant selection levels or options via displayed pull down menus, and the user can select between various types and sources of medical implant graphical models, and may select different viewing modes for different types of medical transparency (x-ray film, MRI scan, CT scan, etc.). The user can expand/shrink, rotate, translate or otherwise spatially manipulate the displayed implant image on the LCD screen with respect to the superimposed medical transparency and the image thereon, using touchscreen, keyboard and/or mouse controls, until an exact size match, scale or correlation is acquired for the implant image with respect to the image on the superimposed medical transparency. The user can additionally display and manipulate tool images, such as a scaling ruler, protractor, electronic pen/pencil, or a sphere or cylinder of predetermined size, on the LCD screen, to facilitate the scaling of the implant image to the image on the superimposed medical transparency. The displayed implant image is compared or correlated to the underlying image on the medical x-ray, and the displayed image will generally go through one or more iterations of spatial manipulation via, translation, xe2x80x9czoom,xe2x80x9d and/or rotation.
Once the implant image has been xe2x80x9cmatchedxe2x80x9d or optimally scaled or correlated to the image on the medical transparency, the implant image and its dimensions, together with other information, are xe2x80x9csavedxe2x80x9d or stored on the computer, and may be printed or exported by downloading to a floppy disc or transferred via network communication to another computer. The stored information about the implant image may be supplemented by input from a physician for use in pre-operative planning and post-operative outcome analysis. If the implant image corresponds to an actual implant which is stored in inventory, the computer can perform an inventory update to note that a particular implant item is being selected for use and that a replacement implant item should be ordered or otherwise acquired to maintain the inventory. The computer can periodically monitor inventories of implant items corresponding to the displayable implant images, and advise users of the availability of such implants when image selections are made. The computer can also record and export non-confidential patient data to external market data services, communicate with remote xe2x80x9celectronic catalogsxe2x80x9d and new product data bases for updating the implant image selections for the user, and accessing advertising databases. The computer can also be used to contact an implant manufacturer representative via computer network to order an implant item corresponding to a selected implant image, or to allow a surgeon to ask questions to manufacturer representatives regarding possible implant selections
An object of the invention is to provide an image comparison apparatus and method which allows graphical models or images of items such as medical implants to be displayed and manipulated in superposition to a transparent medium such as a medical x-ray.
Another object of the invention is to provide an image comparison apparatus and method which allows quick and easy interchangeable superposition of transparent media with a digital display.
Another object of the invention is to provide an image comparison apparatus and method allows for a superimposed display, transparent medium and back light to be releasibly assembled and held securely together in a stationary relationship so that the transparent medium will not undergo unwanted movement with respect to the display during comparison operations.
Another object of the invention is to provide an image comparison apparatus and method which does not require the user to hand-hold or hand-position a display with respect to an underlying transparency, and thus leaves both of the user""s hands free for other work.
Another object of the invention is to provide an image comparison apparatus and method which is compatible with and quick and easy to use in standard medical and dental preoperative planning environments and post-operative outcome analysis environments.
Another object of the invention is to provide an image comparison apparatus and method which allows display and manipulation of tools commonly used in the design, scaling and selection of medical implants and prostheses.
Another object of the invention is to provide an image comparison apparatus and method which provides a user interface which can intuitively be used by surgeons without training.
Another object of the invention is to provide an image comparison apparatus and method which eliminates guesswork from the medical implant selection process and allows fast and accurate design, scaling and selection of medical implants.
Another object of the invention is to provide an image comparison apparatus and method which allows inventory updating and periodic inventory monitoring of implant items.
Another object of the invention is to provide an image comparison apparatus and method which provides electronic access to remote market data services, new product information, electronic catalogs and advertising materials.
Another object of the invention is to provide an image comparison apparatus and method which provides for contacting implant manufacturer representatives via computer network for ordering implant items or making inquiries regarding implant selections.
Further objects and advantages of the invention will be brought out in the following portions of the specification, wherein the detailed description is for the purpose of fully disclosing the preferred embodiment of the invention without placing limitations thereon.